Girl X suffered worst treatment: inquest

Criminals, drug addicts and predatory carers subjected a teenage girl, who was allegedly sexually abused in NSW homes and overdosed on a fatal drug cocktail, to some of the worst treatment an experienced case worker had ever seen.

Girl X died in hospital aged 15. She had been used, abused and lured into the world of drugs, and probably prostitution, by some of the adults who were meant to care for her.

She took a fatal hit of heroin and methamphetamine in April 2014.

The case worker assigned to her by the government as she moved from a home where two carers had allegedly raped her as a 14-year-old to UnitingCare-run Gordon House, told the inquest into her death her life was the "most complex" he had encountered.

"She was the child who had the least reason to trust adults," he said on Wednesday.

"If a young person had a right to tell adults to f*** off it was (Girl X)."

The girl had been taken from her family home at the age of one. After years of failed placements she ended up a ward of the state.

Years later, during a stint in foster care in Queensland, she deliberately overdosed to force authorities to remove her from a carer who was sexually abusing her and her younger twin brothers, the case worker told the inquest.

"If you could write a textbook on how to traumatise a child, it would be (Girl X)," he told Deputy State Coroner Derek Lee.

The girl moved to Gordon House in early 2013 but by the end of the year carers were concerned about her drug and alcohol abuse and the people she was spending time with.

"Things just escalated alarmingly," the carer, who can't be identified, said.

"There were really serious criminal types who were using her vulnerability.

"We were desperately worried about her day-to-day survival."

Girl X would go missing from the refuge regularly and was found unconscious in a Fairfield park after a seven-week absence.

"There is actually very little you can do when a child goes missing," the carer said.

"It's very scary."

When she was staying at the home, unauthorised adult male visitors snuck into her room.

Some of the Gordon House carers thought Girl X needed a higher, more intense level of care.

But when asked if she would have benefited from being ordered into a home where children were sedated and restrained, the inquest heard it would have been one more disruption to her chaotic life.

Further, there were likely not enough spots at the six-bedroom house, the inquest heard.

The inquest heard the girl had undertaken a course as a barista at a cafe near Gordon House.

She often went to work three to four times a week, despite only being required to attend once a week.

Those who knew the girl have all become emotional as they spoke about her moments of brightness and regular efforts to make others happy.

Her family is expected to make a statement on her behalf as the four-day hearing wraps up on Thursday.